I got diagnosed with low t and an under active thyroid.
The endo told me the low t was due to my under active thyroid so she put me on erfa thyroid 30mcg. Starting with half a grain and building up.
I’m now in the second week and building up to 1 grain. But I’m feeling shitty now I’m the 2nd week, while the first week went pretty good. Symptoms 2nd week; no energy, no motivation, lack of libido.
Initially I went to the endo because of low testosterone symptoms. (Lack of libido, ED, tired after training..)
Some info about me:
MALE
31 years old
95 kg
185cm
Struggling with low t for the last 10 years.
I don’t drink but sometimes I do smoke some mary J.
My question:
- do I have a underactive thyroid?
- will I feel better on this thyroid erfa protocol?
- can my low t be restored with thyroid medication and a healthy lifestyle?
- is T- supplementation needed?
My goal:
Get my energy, motivation and libido back!
Please find my lab results attached.
Any feedback, advice or recommendations are welcome!
If any extra info is needed please ask.
Thanks in Advance!
Written by
osokaki
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First of all, what do you mean by 'low T'? Low thyroid hormones? I would have thought that was the same thing as an 'under-active thyroid', no?
Your blood test results are very difficult to read because too small, and they go blurry when enlarged. But I could make out:
TSH 1.72 (0.27-4.2)
FT4 14.2 (12-24)
FT3 5.8 (4.3-7.6)
Is that correct? Any antibodies tested? Any nutrients?
Is this the first thyroid blood test you've ever had? If not, what were the results before this? On the face of it, these results don't look hypo. And normally doctors would not diagnose with such results. They might, however, continue to track your thyroid to see if there is a downward trend with thyroid hormone levels.
So, we need more information to be able to answer your questions, I'm afraid.
With low T i mean low testosterone, i have uploaded more screenshots of my results in the main photo but also under the reply of SeasideSusie.
My Thyroid hormones have been tested before and as i can see the TSH is always between 1.0-1.77 max. FT4 and FT3 are not always tested but are around the same as in this test.
The diagnose came from an endo in Belgium. From the office of DR. Hertoghe. He and his doctors are specialist in hormones, so they say...
As you can see on my labresults my Tesosterone results are very low as a result of an underactive thyroid?
So, if your results have always been more or less the same, I very much doubt you have an under-active thyroid.
Yes, I do know Dr Hertoghe - by reputation. I used to be treated by one of his students in Paris. But, not all Hertoghe doctors are created equal, I'm afraid! Be aware that there are a lot of not so good doctors mascarading under that label, and I wouldn't be surprised if this wasn't one of them.
You say you feel bad on your second week of Erfa - still on 1/2 grain? Could be because you don't need it and your body doesn't like it. Having too much thyroid hormone can be as bad as too little. But, most important question: how did you feel before you started it? Did you have hypo symptoms?
The first week i started erfa on 1 grain 30mcg i was feeling great, active and my mind was working without brain fog so that all went great. Then on day 10 i got real tired and sluggish felling so bad but extremely bad. At this time i thought i had to up my dose because my own hormones were not producing enough. When i upped my dose on day 11 to 2 grains (60mcg) i really felt bad, had to lay down because i had no energy, at the end of that day my hearth started racing and i could sleep.
Next day i wanted to contact my endo but couldnt get a reach on her so i decided to quit taking the Erfa for 5 days, on the 6 day i started with half a grain and now 8 days later im back on 1 grain (30mcg). Still feeling shitty.
She told me in the beginning that i would take time to adjust your hormones but all that she could see in my labresults and body is that my thyroid was underactive and this was the mother of all my problems..
How i felt before?
Well when i have stress because of work of wife i had a recuperation time of 3 days. Same with going to the gym or go out drinking. Always took so long to regenerate. This also was because of the underactive thyroid, the endo explained me.
Im a bit stuck now, because really i would of think all problems are due to the low testosterone levels...
Well, could be. But, in any case, I would say that 1/2 grain was too much to start with. And, increasing to one whole grain after two weeks was definitely too much.
We always recommend starting on 1/4 grain for two weeks, then increasing by 1/4 grain every two weeks until reaching one grain. Then, hold for six weeks and retest, see how you feel. Could just be too much too soon.
OK, just seen your reply to Susie. So, you didn't start on too much. Well, if I were you, I'd increase slowly to 1 grain, and then hold for six weeks, as I said. Retest and see how you feel.
Low T3, to be precise. But, my theory is that, if your FT3 is too low for you - and we're all different in our needs for thyroid hormone - your body won't be able to handle cholesterol correctly, which is why it builds up in the blood. If the supply of cholesterol to the adrenals is cut off, or reduced, then they won't be able to make as much in the way of sex hormones as they should. These things are all linked. So, that could be why your testosterone is low.
I am a bit confused, Because in the beginning you did not quite understand why I was put on erfa while later in the conversation you stated to keep upping the dose till I get to 1 grain.
Could you tell me now you know the story and lab results if it’s ok to keep taking the erfa medication?
You didn't tell me if I got these numbers right from your photo. I couldn't see them very clearly. But, assuming they are...
I'm surprised you got diagnosed with these numbers. Normally, doctors only look at the TSH, and your TSH is unequivocally 'normal' (euthyroid).
Your FT4 is low at 16.62%, there's no denying that. But, that might just be your usual level. As we never get tested when we're healthy, we cannot know what our levels are like when we are well, so don't really know when things go off. As I say, doctors usually just look at the TSH, and as yours is euthyroid, they would just dismiss you as not having a thyroid problem - irrational, but still.
Your FT3, on the other hand is well and truly euthyroid. So, even a Hertoghe doctor could be forgiven for thinking you don't have a problem.
On the other hand, as I said before, it often happens that when a gland is failing, for whatever reason, the thyroid priviliges the production of T3 at the expense of T4, to keep the FT3 level stable, because T3 is the active hormone.
Which is why I asked you if this is your first test. If it had been, I would have said continue to keep an eye on it and see what happens. You don't appear to be in desperate need of more thyroid hormone. However, as I said, maybe you do, but we can't know because we're never tested when healthy to find out what our euthyroid levels are. And, you said you had been tested before but your levels are usually about the same as this test. Well, this could mean that these are your euthyroid levels. But, we just don't know. There's no way of telling except if taking thyroid hormone makes you feel better. In which case, you did need it. So, as you'd already started taking it, why not carry on and see what happens? It's not going to hurt you on such a low dose.
Then came the question about the cholesterol. You said it's high. High cholesterol used to be a means of diagnosing hypothyroidism - before they invented the wretched TSH test! So, sounds as if your body thinks your T3 is too low. If the cholesterol comes down, and the testosterone rises when taking NDT. Then diagnosing you with hypothyroidism was the right call.
Hope that's not too convoluted and confusing, but those were the paths my logic followed - twisted though they may be!
Your explanation does make sense so i wil keep taking the thyroid meds till i hit 1 full grain (2x Tabs 30mg).
I have another apointment with the Endo in Brussel on 20/06, i wil do lab test again just before i go.
Because i was feeling so "off" and tired, i wanted to know if im taking the correct dosage or if i am making the right choice to take the meds in the first place.
But since im still in the begin phase i wil follow your advice and see where we land.
So i wil just proceed to take 1tab (30mg) for the next 2 weeks and then up my dose per 1/4 of grain. (half a tab)
I just hope the brainfog and tiredness wil go away soon.
Thyroid problems run in our family by the way so thats another reason the Endo is looking closely at that.
I will post updates here as i proceed in the thyroid protocol. Would be amazing to see if it all plays out like you and my Endo think it wil.
Hopefully much energy and a good life in the near future!
No-one can know that but you, by the way you feel. With hormones, no-one can forsee what dose you're going to eventually need. You just have to start low and work up slowly. You'll know when you get there.
I'm on a PC with a large screen and it's not possible to read your test results. Maybe you can remove that image then resubmit them, one page in your first post then put the second page in a "Reply" (only one image per post can be included).
Also, it looks like they not in English, maybe you can translate for those of us who don't know whatever language it is and can't work out the test names.
The endo told me the low t was due to my under active thyroid so she put me on erfa thyroid 30mcg. Starting with half a grain and building up.
I’m now in the second week and building up to 1 grain. But I’m feeling ***** now I’m the 2nd week, while the first week went pretty good. Symptoms 2nd week; no energy, no motivation, lack of libido.
Did you endo tell you you'd feel great immediately? I'm afraid thyroid hormone replacement doesn't work like aspirin for a headache, it needs time to build up, you are replacing hormones that your body can't make enough of so it can take months to reach a point where you feel back to your old self. Protocol is start low and gradually build up, you can't rush this, so you start on half a grain, wait a couple of weeks then add another half a grain, then very gradually build up over weeks/months to what is the right dose for you.
This is on the low side. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 ng/L (or pg/ml) to at least 450 ng/L because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 ng/L."
You might want to consider improving this level.
Homocysteine is over range so presumably your doctor has discussed this with you. I know nothing about this so can't comment (and I can't read that language to know what the note says).
Magnesium and zinc are marked with * and I don't know why as both are in range.
Lipids
Triglycerides are very high and this is more important than your out of range cholesterol tests.
Triglycerides are a type of blood fat and if you have too much this contributes to the risk of heart disease and possibly other medical conditions. You need to discuss this with your doctor and address this.
Vit A is over range, this is a fat soluble vitamin and too much builds up and can become toxic. You need to consider why this is high (supplements? too much food containing Vit A such as liver?)
Glucose is over range and insulin is very high. Not my area of expertise so again surely your doctor has discussed this with you?
Vit D is in the insufficient category at 25.4ng/L. The Vit D Society and Grassroots Health both recommend a level of 40-60ng/L so you need to consider supplementing to improve your level by taking D3 plus it's important cofactors of magnesium (helps the body convert D3 into it's usable form) and Vit K2-MK7. Taking D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arterties, kidney stones, etc.
D3 and magnesium should be taken 4 hours away from thyroid meds, Vit K2-MK7 should be taken 2 hours away from thyroid meds.
Thyroid results
A normal healthy person would generally have a TSH no higher than 2, often around 1, with FT4 around mid-range-ish. Your TSH fits in with this but your FT4 is on the lowish side at around 24.62% through it's range. However, as none of us are tested for a baseline when healthy then we don't know what's normal for us.
I'm surprised your doctor has prescribed Erfa (you wouldn't get a diagnosis of hypothyroidism in the UK until your TSH was over range or your FT4 below range) and I would have thought that there are other things that need sorting from this set of tests.
It would be helpful to have had folate tested as B12 and folate work together, also ferritin and/or an iron panel.
A high homocysteine level, also called hyperhomocysteinemia, can contribute to arterial damage and blood clots in your blood vessels. High homocysteine levels usually indicate a deficiency in vitamin B-12 or folate. A normal level of homocysteine in the blood is less than 15 micromoles per liter (mcmol/L) of blood.
Weed really kills off motivation/zest for life in some people and will be contributing to low mood low energy. Some people are ok smoking it occasionally but if you’re a chronic user then it’s going to have negative effects on your mind and body. Definitely consider quitting if you can and get support if you’re finding it hard to.
What time of the day did you test your blood cortisol? If the test was done at 9AM it is low and you need further tests.You insulin seems to be very high and you look insulin resistant and pre-diabetic. This is usually associated with low testosterone in males academic.oup.com/jcem/artic...
I can't see anything wrong with your thyroid. I really don't understand why your doctor would think that your thyroid is the problem when you have other evident abnormal test results that need attention.
I am no expert on how much improving a thyroid that looks pretty much okay already would increase testosterone but I am a bit suspicious of your docs advice. Your thyroid seems normalish but your testosterone is way low, it should be up in the twenties. I doubt tweaking an already okayish thyroid will bring about that improvement. I have been a patient at Hertoghe office on and off since 2007 and I know they usually put patients on many different hormones straight away, I wonder what else they gave you which may explain why your not feeling so good? I am very surprised they have not put you on testosterone instead, I suspect Hertoghe himself and the other docs I have seen there would have. If it was me I think I would take a step back from what they are suggesting until you know a bit more about why you have low Testosterone, 7 is very low for your age, do you have hypogonadism?, I would get that checked. If you do I would try and find out the cause before treating it. I was diagnosed with hypogonadism in 2005 and was put on testosterone then I went to Hertoghe’s and they recommended a pile of different hormones some of which I don’t think I needed but got dependant on them.My view as someone who takes a fair variety of hormones is not to take them unless you actually need them, and then only the ones you definitely need. It can be very hard to balance them if you are taking hormones especially a lot of them. On hindsight I wish I had spent more time on trying to rectify the cause of my hormone deficiency instead of right away throwing lots of hormones at it. Checking out the weed effect on testosterone may be a good start. You are young so it’s wise to chose your docs and directions carefully.
Well it’s good you have not been given a bag of many hormones to take. I still think because your thyroid looks okay it is unlikely to produce the increase in testosterone you need. I would be looking at other causes. I suppose if you are keen at worst you could try the erfa for just a few months, it may be wise to ask your doc at Hertoghe’s how long it should take to see if the erfa will increase your Testosterone. I will say again I would be careful about starting hormones you may not need at such a young age. The problem with going to seeing a private hormone clinic is it very unlikely that they will say to you that you don’t need hormones. It’s that old saying “ a man with a hammer thinks the world is a nail”.I wish you luck and maybe you could post the outcome of your treatments if you decide to continue.
I wanted to post an update about my results and progress.
So i did a bloodwork test past week and came back positive.
My testosterone almost doubled! see attachment.
I am currently on 1.25 pills of 30mg per pil of ERFA thyroid. And upping the dose just makes me feel tired and week. I even past out for the first time in my life when i was at the doctor to get my blood drawn.
So im happy with the results of my testosterone but my muscles feel week and im not in a good mood or active.
With these symptoms and bloodwork my Endo told me the Thyroid medication is using up the cortisol in my body (low cortisol in bloodwork).
So she put me on Hydrocortisone 10mg every morning.
I really dont want extra hormones in my body and asked if i have to take it for life or just temporary, the answer was that i had to take it for the comming 4-6 month and then tapper off to see what my base line is from there.
What are your opinion on the Hydrocortisone part and is there another (more natural) way to pull the cortisol higher up?
Hi osokaki, I'm a 54 year man with similar symptoms (low mood, low motivation, low energy, brain fog, poor memory). I've been on levothyroxine for years. My testosterone is being tested as a possible cause, though in my case my TSH was too high so I am taking more levothyroxine first.
1) Blood Testing
tl;dr - taking blood tests is like a scientific experiment - you need to control the variables (time, dosing, fasting) - this allows realistic comparisons between the past and now.
The body's circadian rhythm regulates the production of hormones on a 24-hour cycle, so TSH, cortisol, testosterone, etc all vary over 24 hours. You need to control the time of the test to be similar each time, and also to fast and there's some protocol about when to take the last thyroid medication (I don't know what that is for NDT/erfa).
2) Testosterone
I've been looking at (too many!) YouTube videos on testosterone. Many of them are "way out" with power lifters, etc. Perhaps you could get your blood results (including the PREVIOUS testosterone results taken before you took erfa) looked at by testosterone specialists? I am getting mine done with a reputable specialists. Feel free to PM me for who I'm using.
There are natural ways to increase testosterone (google it) including more fat (precursor to sex hormones), more sleep, more sun, less "estrogenic" foods, reducing stress, mores sex/less masturbation (I'm not saying you do!!), etc. You need to do your own research - I'm not a Dr!
3) Symptoms
Have you considered that your low mood, etc is due to depression or anxiety? I know I feel depressed and I'm struggling to motivate myself to find a new job. Canabis use might make things worse, or *mask* these feelings. I was also diagnosed with ADHD recently and that can cause low motivation if you're not interested in your work/life.
There are many reasons for low mood, motivation, etc - not just hormones. We need to take control of our health and well being. Good luck!
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